Colorectal Cancer Surgical Pathology: Comparative Study in Lebanon Before and After the Economic Collapse

Background and Objectives

Colorectal cancer (CRC) screening and early detection reduce mortality. Curative treatment is based on surgical resection, and pathological analysis plays a key role in management. In Lebanon, the impact of the COVID-19 pandemic on healthcare has been compounded by an unprecedented socio-economic crisis in 2020. This has deteriorated access to medical care and could have delayed CRC diagnosis and treatment. The study evaluates the impact of the economic collapse on CRC in Lebanon by comparing characteristics of patients operated on in 2020 and 2021 (post-crisis period) to those operated on in 2018 and 2019 (pre-crisis period).

Methods

This retrospective study included patients who underwent surgical resection for colorectal adenocarcinoma at a tertiary care center in Lebanon between 01/01/2018 and 12/31/2021. Patients were divided into two groups according to the corresponding period, and the demographic, clinical, and pathological characteristics were compared.

Results

Among the 169 patients included, 89 (53%) were operated on in the pre-crisis period and 80 (47%) in the post-crisis period. We reported that in the post-crisis period: more patients presented with clinical complications requiring urgent admission (30% vs. 16%), more tumors were classified as T4b (10% vs. 2%), and more tumors presented lymphatic emboli (65% vs. 45%), perineural (51% vs. 22%) and perivascular invasion (40% vs. 19%) (p < 0.05).

Conclusions

This study highlights the worsening of clinical and pathological indicators of poor prognosis by the current economic crisis, and this could potentially be translated into a reduction of survival.